RESUMO
Cardiovascular compute tomography (CT) is now a robust tool for the evaluation of coronary artery atherosclerosis and stenosis. A number of single-center studies, and now multicenter trials, have shown that the diagnostic accuracy of this tool compares favorably with the reference standard of conventional coronary angiography. Of course, CT angiography does not allow for the assessment of the functional significance of a given coronary lesion. However, recent reports have shown that myocardial perfusion imaging is possible with CT, opening up the possibility of providing a comprehensive evaluation of both coronary anatomy and physiology with one examination. This article reviews the principles, technical considerations, and the potential of stress myocardial perfusion imaging with CT.
Assuntos
Angiografia Coronária/métodos , Teste de Esforço/métodos , Aumento da Imagem/métodos , Imagem de Perfusão/métodos , Tomografia Computadorizada por Raios X/métodos , Angiografia Coronária/instrumentação , Teste de Esforço/instrumentação , Humanos , Aumento da Imagem/instrumentação , Imagem de Perfusão/instrumentação , Sensibilidade e Especificidade , Avaliação da Tecnologia Biomédica , Tomografia Computadorizada por Raios X/instrumentaçãoRESUMO
Heart failure remains a leading cause of hospitalisation and death. Treatment of acute heart failure has not improved as rapidly as treatment for chronic heart failure. There are three classes of inotropic agents that are in use at present: the catecholamines, phosphodiesterase inhibitors and calcium sensitisers. Cardiac-specific myosin ATPase activators are a novel class of agents designed to improve myocardial contractility by accelerating the productive phosphate-release step of the crossbridge cycle. This article reviews the mechanism of action of myosin ATPase activators, the results of preclinical and Phase I studies and their potential role in the management of heart failure.
